Enrolling as an Out-of-State Alabama Medicaid provider

If a Hurricane Katrina evacuee covered by Alabama Medicaid presents in another state for a medical service, the provider should enroll with Alabama Medicaid in order to be reimbursed.  Two special enrollment forms are available to expedite this enrollment process.

Simplified Provider Enrollment Forms for Out-of-State-Providers

• Application for Out-of-State Pharmacies
• Application for Other Out-of-State Providers
• Other Provider Enrollment Forms

If you have questions regarding the appropriate form to complete or guidance when completing the forms, please contact Provider Enrollment at (334) 215-0111.

Temporary Enrollment for Dental Providers Displaced by Hurricane Katrina

Dental providers from federally-recognized disaster areas who have obtained a temporary license from the Alabama Board of Dental Examiners are eligible to enroll with Alabama Medicaid.  Click here for an application form.

Interested dental providers who have not yet obtained an Alabama Dental License should call the Alabama Board of Dental Examiners at 205-985-7267 for assistance.

To learn more about the Alabama Dental Program's covered services and policies, click here

• Nursing Home Services – (334) 242-5684
• Pharmacy Services – (334) 242-5050
• Medical Services – (334) 353-5533
• Dental Program – (334) 242-5472
• Agency Contact List
• Alabama Medicaid Recipient Inquiry Unit – (800) 362-1504

Helpful Links:

• Alabama Medicaid Provider Manual
• Alabama Medicaid Eligibility Information
• Mississippi Medicaid Home Page
• Louisiana Medicaid Website

Click here for news updates from alabama.gov, the official website of the State of Alabama.